Transcription of Certificate of Assumed Name - New York Department of …
1 Page 1 of 2 DOS-1338-f-l (Rev. 10/13) Certificate of Assumed NamePursuant to General Business Law 130 NYS Department of State Division of Corporations, State Records and Uniform Commercial Code One Commerce Plaza, 99 Washington Ave, Albany, NY 12231-0001 REAL name OF ENTITY:1a. FICTITIOUS name , IF ANY, OF FOREIGN ENTITY (Not Assumed name ):2. FORMED OR AUTHORIZED UNDER THE FOLLOWING NEW york LAW (Check one):3. Assumed name :4. PRINCIPAL PLACE OF BUSINESS IN NEW york STATE (MUST INCLUDE NUMBER AND STREET). IF NONE, CHECK THIS BOX AND PROVIDE OUT-OF- STATE ADDRESS:5.
2 COUNTY(IES) IN WHICH ENTITY DOES OR INTENDS TO DO BUSINESS:AlbanyAlleganyBronxBroomeCattar augusCayugaChautauquaChemungChenangoClin tonColumbiaCortlandDelawareDutchessErieE ssexFranklinFultonGeneseeGreeneHamiltonH erkimerJeffersonKingsLewisLivingstonMadi sonMonroeMontgomeryNassauNew YorkNiagaraOneidaOnondagaOntarioOrangeOr leansOswegoOtsegoPutnamQueensRensselaerR ichmondRocklandSt. LawrenceSaratogaSchenectadySchoharieSchu ylerSenecaSteubenSuffolkSullivanTiogaTom pkinsUlsterWarrenWashingtonWayneWestches terWyomingYates6.
3 ADDRESS OF EACH LOCATION, INCLUDING NUMBER AND STREET, IF ANY, OF EACH PLACE WHERE THE ENTITY CARRIES ON, CONDUCTS OR TRANSACTS BUSINESS IN NEW york STATE. Use page 2 if needed. The address(es) must be a number and street, city state and zip code. The address(es) reflected in paragraph 6 must be within the county(ies) indicated in paragraph 5. If none, check the box:Business Corporation LawEducation LawReligious Corporations LawOther (specify law):Limited Liability Company LawNot-for-Profit Corporation LawRevised Limited Partnership ActALL COUNTIES (or check applicable county(ies) below) name of Signer:Signature:Filer: name :Mailing Address:City, State and Zip Code:NOTE: This form was prepared by the New york State Department of State.
4 You are not required to use this form. All documents should be prepared under the guidance of an attorney. The Certificate must be submitted with a $25 fee. For corporations, the Department of State also collects the following, additional, county clerk fees for each county in which a corporation does or intends to do business as indicated in paragraph 5: $100 for each county within New york City (Bronx, Kings, New york , Queens and Richmond) and $25 for each county outside New york City. All checks over $500 must be of Signer (Check one):Officer of the CorporationGeneral Partner of the Limited PartnershipMember of the Limited Liability CompanyManager of the Limited Liability CompanyAuthorized PersonNo New york State Business LocationPage 2 of 2 DOS-1338-f-l (Rev.)
5 10/13)6. ADDRESS OF EACH LOCATION, INCLUDING NUMBER AND STREET, IF ANY, OF EACH PLACE WHERE THE ENTITY CARRIES ON OR CONDUCTS OR TRANSACTS BUSINESS IN NEW york STATE: (Continued)Page 2 (If needed)(For office use only)
